After pregnancy, sex can feel different. You are not alone. Anxiety and discomfort during the initial encounters are common. In most cases, sex becomes more comfortable and enjoyable over time, as the tissues fully recover (as as you find more time for yourself and your partner – which is a feat unto itself!). If pain during intercourse persists for a few months or more, you do not need to accept this as your new normal. It’s time to see a medical professional. I recommend starting with your OB/GYN or primary care physician, and requesting a referral to a pelvic floor physical therapist. Pain is our body’s way of telling us a problem exists that needs to be solved. Thankfully your body is resilient, and there are solutions.
Sometimes the solution is as simple as a good, water-based lubricant. Due to postnatal hormones, especially if you’re breastfeeding, excessive dryness can lead to pain during penetration. In some cases, painful intercourse can indicate scarring or tissues that did not heal properly after birth. It’s best to identify these as soon as possible and seek appropriate medical treatment. In some cases physical therapy for scar tissue might be sufficient. In others, surgery could be indicated. But the good thing is that there are resources for you to fully heal and to embrace physical intimacy again.
One of the more common causes of chronic pain during intercourse stems from core weakness and pelvic instability, which often accompany diastasis recti (abdominal separation). When the hips and pelvis are hypermobile due to weak, overstretched abdominal and pelvic floor tissues, other muscles compensate. This can lead to spasms, joint misalignment, and patterns of chronic tightness (hypertonicity) that cause pain during penetration. Other common symptoms of a tight pelvic floor include tailbone pain and constipation. Physical therapy presents a host of interventions to restore balance and freedom from pelvic pain, including targeted core strengthening, manual release techniques, and biofeedback tools to gain control over both engagement and release of the deep core muscles.
In addition to 1:1 physical therapy, our EMbody programs address many of the causal factors of pelvic instability, including abdominal muscle weakness, pelvic floor weakness, and abdominal separation (diastasis recti). Our foundational core exercise, which informs every move in every workout, coordinates engagement of the transverse abdominis and the pelvic floor while exhaling to decrease intra-abdominal pressure. This deep core activation strengthens the muscles and resolves diastasis recti, improving core integrity and pelvic stability. We also provide breath coaching, specific guidance on when (and when not) to Kegel, and tips to maintain a neutral and relaxed pelvic floor. Many women have used our app as a complement to 1:1 appointments with a pelvic floor PT, and some have used exclusively Every Mother to dramatically improve their core health and free themselves from pain during intercourse.
Don’t feel you have to settle for painful sex after baby. Reach out for help. This is a powerful act of self-love, and I encourage you to do this for yourself first and foremost. Not for your partner, not for your relationship. For you. Accessible resources exist to support a full recovery so you can enjoy sexual intimacy, and even nurture a richer, more satisfying sex life than ever before. Release the pain, and embrace the pleasure.